An inflammatory pseudotumor within the thoracic epidural area presenting with progressive paraplegia: a histopathological analysis with scientific and radiological uncertainty. Case report with literature assessment.
Eur Backbone J. 2016 Could;25 Suppl 1:75-9
Authors: Kanagaraju V, Rai D, Alluri RV, Prasanna C, Shyam Sundar V, Arvind Kumar SM, Venkatesh Kumar N
INTRODUCTION: Inflammatory pseudotumors (IPTs) are benign lesions with unknown etiology, in all probability an immunological response to a traumatic or an infective insult or typically thought of as an IgG4-related autoimmune dysfunction. It might probably happen as an remoted or multi-centric lesion and are reported to contain virtually all components of the human physique. Though lung and orbital IPTs are reported generally, central nervous system involvement is a uncommon prevalence. Solely seven circumstances of spinal epidural IPTs have been reported thus far. These are clinically and radiologically a analysis of exclusion. It’s an unique histopathological analysis.
CASE REPORT: We current right here a 49-year-old feminine with 2 months historical past of progressive weak spot in decrease limbs, with no historical past suggestive of any traumatic, infective, inflammatory, or neoplastic pathology. Each scientific and radiological investigations have been inconclusive. There was a mass lesion within the epidural area (predominantly within the posterior and proper lateral area) at T1-T3 vertebral ranges compressing the thoracic spinal twine. Contemplating the progressive nature of her neurological deficit, an emergency decompressive laminectomies of T1-T3 vertebrae have been accomplished with excision of the compressive mass lesion. Histopathological examination confirmed a wealthy lympho-plasmacytic cell infiltrates with storiform spindle cells and dense fibrosis, which was diagnostic of IPT. Submit-operatively there was a speedy restoration in neurology and she or he turned ambulatory on the finish of two weeks. The aim of this case report is to debate the scientific, histopathological and radiological options, differential analysis, administration, and prognosis of spinal IPT on the background of related literature assessment.
PMID: 26155896 [PubMed – indexed for MEDLINE]